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MRCP 1 > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

PBC: associations

A

Sjogren’s, RA, systemic sclerosis, thyroid disease

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2
Q

PBC: features

A

Fatigue, pruritis, cholestasis, hyperpigmentation

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3
Q

PBC; Dx

A

AMA, raised IgM

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4
Q

PBC; Mx

A

Ursodeoxycholic acid

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5
Q

Achalasia; features

A

Dysphagia of liquids and solids

Regurgitation

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6
Q

Achalasia; Ix

A 
Oesophageal manometry
Barium swallow (bird's beak)
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7
Q

Peutz-Jeghers Sx; what?

A

AD condition with hamartomatous polyps in GI tract

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8
Q

Peutz-Jeghers; features

A

Hamartomatous polyps in GI tract
Pigmented lesions on lips, mouth, face, palms and soles
Obstruction
GI bleeding

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9
Q

Acute fatty liver of pregnancy: features

A

Abdo pain, n&v, headache, jaundice, hypoglycaemia

Elevated ALT

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10
Q

Intrahepatic cholestasis of pregnancy: features

A

pruritus, raised bilirubin

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11
Q

Intrahepatic cholestasis of pregnancy; Mx

A

Ursodeoxycholic acid

Weekly LFTs

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12
Q

Causes of C. dif infection

A

Clindamycin, cephalosporins and PPIs

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13
Q

C. dif; Mx

A

Po metronidazole

PO vancomycin

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14
Q

Antibody used in C dif

A

Bezlotozumab

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15
Q

Whipple’s disease; features

A 
WHIPPLE
Watery diarrhoea
Hyperpigmentation of skin
I (eye signs)
Pleurisy
Pericarditis
LN
Enteric involvement
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16
Q

Whipple’s disease; Biopsy

A

Macrophage deposition with periodic acid-Schiff granules

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17
Q

Sulphasalazine; SE

A

Rashes, oligospermia, headache, Heinz body anaemia, megoblastic anaemia, fibrosis

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18
Q

Mesalazine; SE

A

GI upset, headache, agranulocytosis, pancreatitis, interstitial nephritis

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19
Q

Gastrin; source

A

G cells in antrum of stomach

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20
Q

Gastrin; stimulus

A

Stomach distension
Vagal nerve
Peptides / amino acids

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21
Q

Gastrin; actions

A

Increases parietal cell acid secretion
Increases pepsinogen and IF secretion
Increases gastric motility

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22
Q

CCK; source

A

I cells in upper small intestine

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23
Q

CCK; stimulus

A

Partially digested proteins and triglycerides

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24
Q

CCK; actions

A

Increases pancreatic secretions

GB contraction and relaxation of sphincter of Oddi

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25
Secretin; source
S cells in small intestine
26
Secretin; stimulus
Acidic chyme, fatty acids
27
Secretin; actions
Increases HCO3 secretion | Decreases gastric acid secretion
28
VIP; source
Small intestine and pancrease
29
VIP; action
Stimulates secretion by pancreas and intestine | Inhibits acid secretion
30
Somatostatin; source
D cells in pancreas and stomach
31
Somatostatin; action
Decreases acid and pepsin secretion
32
Hepatomegaly; cirrhosis
Non-tender firm liver
33
Hepatomegaly; malignancy
hard, irregular, liver edge
34
Hepatomegaly; RHF
firm, smooth, tender liver edge +/- pulsatile
35
Crohn's; inducing remission
1. steroid + 5-asa 2. azathioprine / MTX 3. Infliximab
36
Crohn's; maintaining remission
1. azathioprine 2. MTX 3. 5-asa
37
Carcinoid tumours: what?
Liver metastases and release serotonin into systemic circulation
38
Carcinoid tumours; features
Flushing, diarrhoea, bronchospasm, hypotension, RS valve disease
39
Carcinoid tumours; Ix;
urinary 5-HIAA
40
Carcinoid tumours; Mx
Somatostatin analogues - octreotide
41
LFTs; hepatic
ALT, AST
42
LFTs; biliary
GGT, ALP
43
HBV; vaccinated
HbSAg; negative Anti-HbSAg; positive Anti-HbCAg; negative
44
HBV; natural immunity
HbSAg; negative Anti-HbSAg; positive Anti-HbCAg; positive
45
HBV; acute infection
HbSAg; positive Anti-HbSAg; negative Anti-HbCAg; positive (IgM)
46
HBV; chronic infection
HbSAg; positive Anti-HbSAg; negative Anti-HbCAg; positive (IgM negative)
47
SBP; Dx
Paracentesis; neutrophils >250
48
SBP; Mx
IV cefotaxime
49
Bariatric surgery; referral criteria
No RF; BMI >40 | RF; BMI >35
50
Hepatorenal syndrome: type 1
Rapid progression | Very very poor prognosis
51
Hepatorenal syndrome: type 2
Slowly progressive
52
Hepatorenal syndrome: Mx
terlipressin
53
What is Dubin Johnson syndrome?
Benign AR disorder resulting in hyperbilirubinaemia
54
Drugs inducing hepatocellular damage (10)
``` Paracetamol Anti-epileptics (valproate, phenytoin) MAOIs Halthane Anti-TB Statins Alcohol Amiodarone Methyldopa Nitrofurantoin ```
55
Drugs inducing cholestasis (6)
``` COCP Penicillins Steoids Phenothiazines Sulphonylureas Fibrates ```
56
Drugs inducing cirrhosis (3)
Methotrexate Methyldopa Amiodarone
57
Acute pancreatitis: causes
``` GET SMASHED Gallstones Ethanol Trauma Steroids Mumps Autoimmune Scorptio Hypertriglyceridaemia ERCP Drugs ```
58
Autoimmune hepatitis: type I
Anti-nuclear antibodies +/- anti-smooth muscle antibodies | Affects adults and children
59
Autoimmune hepatitis: type II
Anti-liver / kidney microsomal type 1 antibodies | Affects children
60
Autoimmune hepatitis: type III
Soluble liver-kidney antigen | Affects middle-aged
61
Angiodysplasia: associations
Aortic stenosis
62
Autoimmune hepatitis: associations
HLA B8 DR3
63
Bile acid malabsorption: investigation
SeHCAT
64
Bile acid malabsorption: Mx
Cholestyramine
65
C. dif: Management
PO vancomycin PO fidaxomicin PO vancomycin +/- IV metronidazole
66
Barrett's oseophagus: histology
Columnar epithelium
67
Monitoring Rx in haematochromatosis
Ferritin and transferritin
68
Plummer Vinson syndrome: what?
Dysphagia, glossitis, IDA
69
Acute pancreatitis: severe (6)
``` >55 Hypocalcaemia Hyperglycaemia Hypoxia Neutrophilia Elevated LDH and AST ```
70
Child Pugh Score
``` Ascities Bilirubin Albumin PT Encephalopathy ```
71
Coeliac; HLA
HLA DQ2 and HLA DQ8
72
Crohn's histology
Inflammation in all layers of mucosa Increased goblet cells Granulomas
73
UC histology
No inflammation beyond submucosa Crypt abscess formation Depletion of goblet cells
74
Crohn's endoscopy
Deep ulcers Skip lesions Cobble stone appearance
75
UC endoscopy
Psudopolyps
76
HSM: causes
``` CLD with portal HTN Infections; glandular fever, malaria, hepatits Lymphoproliferative disorders Myeloproliferative disorders Amyloidosis ```
77
HRS: pathophysiology
Splanchnic vasodilation
78
Maltase
Maltose --> glucose + glucose
79
Sucrase
Sucrose --> fructose + glucose
80
Lactase
Lactose --> glucose and galactose
81
Melanosis coli
Associated with laxative abuse
82
UC Inducing
Rectal aminosalicylate PO aminosalicylate Steroid
83
UC Inducing in severe disease
Topical aminosalicylate and PO aminosalicylate
84
UC Inducing in severe colitis
IV steroids / ciclosporin
85
Gastric MALT lymphoma; associations
H. pylori infection
86
Oesophageal adenocarcinoma: RF
``` GORD Barrett's Smoking Achalasia Obesity ```

MRCP 1 (16 decks)

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